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Laparoscopic Roux-en-Y gastric bypass: comparison between hand-sewn and mechanical gastrojejunostomy

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Abstract

The laparoscopic Roux-en-Y gastric bypass (LRYGB) is one of the ideal operations in the treatment of morbid obesity. There are several variations in the operation, especially during the construction of the gastrojejunostomy (GJA). From June 2006 to September 2008, 104 consecutive obese patients underwent LRYGB. The procedure was standardized, with the exception of the construction of the GJA, which was linear-stapled in 51 patients and hand-sewn in 53 other patients. A retrospective analysis was performed to compare the procedures. The series comprised 81 women and 23 men with a median age of 44 years, and a median BMI of 46.7 kg/m2. There was no significant difference between the two groups of patients with respect to age, gender, BMI, ASA, and previously failed bariatric surgery. There was no significant difference between the two groups with respect to mortality, conversion, early reoperation, surgical complications, GJA leakage or stricture, and bariatric results. The only significant differences between the two groups were in regards to operating time (190 min for stapled GJA vs. 160 min for hand-sewn GJA, p value 0.029) and operating supply cost (100 Euros less for hand-sewn GJA). In our experience, hand-sewn GJA during LRYGB appears to be as safe as linear-stapled GJA and provides the same bariatric results while remaining slightly less expensive.

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Acknowledgments

The authors thank Ms Antonia Giraud for her editorial assistance and Mr Mathias Bouna Camara for his statistical assistance.

Conflict of interest

The authors disclose no commercial interest in the subject of study and had any financial or material sources from any of the following organizations: National Institutes of Health (NIH); Wellcome Trust; Howard Hughes Medical Institute (HHMI); and other(s). They also respect the ethical rules of medical studies.

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Authors and Affiliations

  1. Department of Endoscopic Surgery, Haut Lévèque Hospital, Bordeaux, France

    Julien Jarry, Tristan Wagner, Antonio Sa Cunha & Denis Collet

  2. Department of Statistics, Pellegrin Hospital, Bordeaux, France

    Marie de Pommerol

  3. 206 rue du Tondu, Résidence la Bruyère, 33000, Bordeaux, France

    Julien Jarry

Authors
  1. Julien Jarry
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  2. Tristan Wagner
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  3. Marie de Pommerol
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  4. Antonio Sa Cunha
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  5. Denis Collet
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Correspondence to Julien Jarry.

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Jarry, J., Wagner, T., de Pommerol, M. et al. Laparoscopic Roux-en-Y gastric bypass: comparison between hand-sewn and mechanical gastrojejunostomy. Updates Surg 64, 25–30 (2012). https://doi.org/10.1007/s13304-011-0126-z

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  • DOI: https://doi.org/10.1007/s13304-011-0126-z

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